安徽省农村居民对基层医疗服务信任度及其影响因素调查

Survey on trust and satisfaction to primary care and its factors among rural residents in Anhui province

目的调查分析安徽省农村居民对基层医疗服务现状的信任程度及其影响因素,为构建分级医疗服务体系和基层医疗卫生资源配置提供参考依据。方法调查问卷通过来自农村、区域分布广泛的本校农村订单定向免费医学生,于2015年利用寒假返乡机会、随机调查其家庭周围的约10户村民,共收集有效问卷739份,分析指标为就诊满意度和对当地基层医疗服务提供者信任程度及其相关因素。结果农村居民感觉到就诊不方便者占54.13%,认为在就诊过程中存在至少1项"不方便"者高达74.70%。其中,"不方便"主要是"候诊时间和候诊秩序(38.29%)""医生的形象、态度和水平(35.86%)""收费的合理性和适宜性(33.42%)"等。多因素Logistic回归分析显示,农村居民对医疗机构提供者信任程度不仅与调查对象年龄、性别等生理因素有关,而且与婚姻状况、文化程度、家庭人口数、住房面积大小和对居住环境满意程度有关,提示社会、经济和行为因素间接地影响了农村居民对基层医疗服务现状的信任程度。结论农村居民对基层医疗提供的医疗服务满意度和信任度均不高,造成这种现象不仅与医疗卫生服务的提供能力直接相关,而且与农村社会经济发展、文明生活方式及和谐社会环境等系统工程建设间接地相关。

Objective To investigate the trust of rural residents in Anhui Province for the primary care and the influencing factors, and provide basis for the construction of classification of medical service system and allocation of basic medical and health resources. Methods A questionnaire survey on the trust and satisfaction to primary care and its factors was conducted among farmers who lived around our representative rural-oriented medical student investigators from wide areas of Anhui province in 2015. A total of 739 valid responses were collected and analyzed. Results Fifty-four point thirteen percent of rural residents argued that the treatment was inconvenient,74.70% agreed that there was at least one ＂convenient＂ item in the treatment process. The ＂ not convenient＂ items mainly included ＂waiting times and waiting order （ 38.29 % ） ＂,＂ the doctor＇ s image, attitude and level （35.86%） ＂ and ＂reasonable and appropriate fees for （ 33.42% ）＂ and so on. Multivariate logistic regression analysis showed that this level of trust not only with physiological factors survey age, sex, etc. , but also to marital status, education level, family size, housing area and the living environment, indirectly suggesting that social, economic and behavioral factors significantly affect the level of trust on the status of rural primary health care services. Conclusion The availability to primary health care institutions for rural farmers should be improved. The trust and satisfaction of rural residents to primary care services should be improved not only direetly by the delivery of health services, but also indirectly by the new rural social and economic development and health lifestyles and harmonious society construction and others.